Provider Demographics
NPI:1154319473
Name:MOESINGER, ROBERT LIONEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LIONEL
Last Name:MOESINGER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3955 HARRISON BLVD
Mailing Address - Street 2:STE U6
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2399
Mailing Address - Country:US
Mailing Address - Phone:801-393-5324
Mailing Address - Fax:801-393-7780
Practice Address - Street 1:3955 HARRISON BLVD
Practice Address - Street 2:STE U6
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2399
Practice Address - Country:US
Practice Address - Phone:801-393-5324
Practice Address - Fax:801-393-7780
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT151175-1205207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D07714Medicare UPIN